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Bourke AG, Jose C. Recurrent complications of PAAG implants during lactation. BMJ Case Rep 2018; 2018:bcr-2017-219688. [PMID: 30396888 DOI: 10.1136/bcr-2017-219688] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 35-year-old lactating woman with pre-existing polyacrylamide gel (PAAG) implants for 10 years presented on numerous occasions following both her pregnancies with bilateral recurrent breast infection, pain and finally massive breast enlargement with a ruptured galactocoele necessitating surgical intervention. As the safety of PAAG for the breastfeeding baby is not known, breastfeeding with PAAG implants is not recommended.
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Affiliation(s)
- Anita Geraldine Bourke
- Department of Radiology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Chaitra Jose
- Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
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2
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Bogetti P, Fraccalvieri M, Cappello G, Balocco P, Mariscotti G, Durando M, Mangia A, Gianfala A, Ruka E, Bruschi S. Novel decision algorithm for the diagnosis of silicone gel breast implant ruptures. EUROPEAN JOURNAL OF PLASTIC SURGERY 2018. [DOI: 10.1007/s00238-018-1434-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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3
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Scotto di Santolo M, Cusati B, Ragozzino A, Dell'Aprovitola N, Acquaviva A, Altiero M, Accurso A, Riccardi A, Imbriaco M. Poly Implant Prothèse (PIP) incidence of rupture: a retrospective MR analysis in 64 patients. Quant Imaging Med Surg 2014; 4:462-8. [PMID: 25525578 DOI: 10.3978/j.issn.2223-4292.2014.08.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Accepted: 08/04/2014] [Indexed: 11/14/2022]
Abstract
AIM OF THE STUDY The purpose of this retrospective study was to describe the magnetic resonance imaging (MRI) features of Poly Implant Prothèse (PIP) hydrogel implants in a group of 64 patients and to assess the incidence of rupture, compared to other clinical trials. MATERIAL AND METHODS In this double-center study, we retrospectively reviewed the data sets of 64 consecutive patients (mean age, 43±9 years, age range, 27-65 years), who underwent breast MRI examinations, between January 2008 and October 2013, with suspected implant rupture on the basis of clinical assessment or after conventional imaging examination (either mammography or ultrasound). All patients had undergone breast operation with bilateral textured cohesive gel PIP implant insertion for aesthetic reasons. The mean time after operation was 8 years (range, 6-14 years). No patients reported history of direct trauma to their implants. RESULTS At the time of clinical examination, 41 patients were asymptomatic, 16 complained of breast tenderness and 7 had clinical evidence of rupture. Normal findings were observed in 15 patients. In 26 patients there were signs of mild collapse, with associated not significant peri-capsular fluid collections and no evidence of implant rupture; in 23 patients there was suggestion of implant rupture, according to breast MRI leading to an indication for surgery. In particular, 14 patients showed intra-capsular rupture, with associated evidence of the linguine sign in all cases; the keyhole sign and the droplet signs were observed in 6 cases. In 9 patients there was evidence of extra-capsular rupture, with presence of axillary collections (siliconomas) in 7 cases and peri-prosthetic and mediastinal cavity siliconomas, in 5 cases. CONCLUSIONS The results of this double center retrospective study, confirm the higher incidence (36%) of prosthesis rupture observed with the PIP implants, compared to other breast implants.
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Affiliation(s)
- Mariella Scotto di Santolo
- 1 Department of Radiology, University "Federico II", Napoli, Italy ; 2 Department of Radiology, Ospedale S.M.delle Grazie, Pozzuoli, Napoli, Italy ; 3 Department of General, Geriatric, Oncologic Surgery and Advanced Technologies, Napoli, Italy
| | - Bianca Cusati
- 1 Department of Radiology, University "Federico II", Napoli, Italy ; 2 Department of Radiology, Ospedale S.M.delle Grazie, Pozzuoli, Napoli, Italy ; 3 Department of General, Geriatric, Oncologic Surgery and Advanced Technologies, Napoli, Italy
| | - Alfonso Ragozzino
- 1 Department of Radiology, University "Federico II", Napoli, Italy ; 2 Department of Radiology, Ospedale S.M.delle Grazie, Pozzuoli, Napoli, Italy ; 3 Department of General, Geriatric, Oncologic Surgery and Advanced Technologies, Napoli, Italy
| | - Nicoletta Dell'Aprovitola
- 1 Department of Radiology, University "Federico II", Napoli, Italy ; 2 Department of Radiology, Ospedale S.M.delle Grazie, Pozzuoli, Napoli, Italy ; 3 Department of General, Geriatric, Oncologic Surgery and Advanced Technologies, Napoli, Italy
| | - Alessandra Acquaviva
- 1 Department of Radiology, University "Federico II", Napoli, Italy ; 2 Department of Radiology, Ospedale S.M.delle Grazie, Pozzuoli, Napoli, Italy ; 3 Department of General, Geriatric, Oncologic Surgery and Advanced Technologies, Napoli, Italy
| | - Michele Altiero
- 1 Department of Radiology, University "Federico II", Napoli, Italy ; 2 Department of Radiology, Ospedale S.M.delle Grazie, Pozzuoli, Napoli, Italy ; 3 Department of General, Geriatric, Oncologic Surgery and Advanced Technologies, Napoli, Italy
| | - Antonello Accurso
- 1 Department of Radiology, University "Federico II", Napoli, Italy ; 2 Department of Radiology, Ospedale S.M.delle Grazie, Pozzuoli, Napoli, Italy ; 3 Department of General, Geriatric, Oncologic Surgery and Advanced Technologies, Napoli, Italy
| | - Albina Riccardi
- 1 Department of Radiology, University "Federico II", Napoli, Italy ; 2 Department of Radiology, Ospedale S.M.delle Grazie, Pozzuoli, Napoli, Italy ; 3 Department of General, Geriatric, Oncologic Surgery and Advanced Technologies, Napoli, Italy
| | - Massimo Imbriaco
- 1 Department of Radiology, University "Federico II", Napoli, Italy ; 2 Department of Radiology, Ospedale S.M.delle Grazie, Pozzuoli, Napoli, Italy ; 3 Department of General, Geriatric, Oncologic Surgery and Advanced Technologies, Napoli, Italy
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Leopardi D, Thavaneswaran P, Mutimer KLA, Olbourne NA, Maddern GJ. Autologous fat transfer for breast augmentation: a systematic review. ANZ J Surg 2013; 84:225-30. [DOI: 10.1111/ans.12202] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2013] [Indexed: 11/26/2022]
Affiliation(s)
- Deanne Leopardi
- Australian Safety and Efficacy Register of New Interventional Procedures-Surgical (ASERNIP-S); Royal Australasian College of Surgeons; Adelaide South Australia Australia
| | - Prema Thavaneswaran
- Australian Safety and Efficacy Register of New Interventional Procedures-Surgical (ASERNIP-S); Royal Australasian College of Surgeons; Adelaide South Australia Australia
| | | | | | - Guy J. Maddern
- Australian Safety and Efficacy Register of New Interventional Procedures-Surgical (ASERNIP-S); Royal Australasian College of Surgeons; Adelaide South Australia Australia
- Department of Surgery; University of Adelaide and The Queen Elizabeth Hospital; Adelaide South Australia Australia
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5
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Challenges in Mammography: Part 2, Multimodality Review of Breast Augmentation—Imaging Findings and Complications. AJR Am J Roentgenol 2011; 197:W1031-45. [DOI: 10.2214/ajr.11.7216] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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6
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Colombo G, Ruvolo V, Stifanese R, Perillo M, Garlaschi A. Prosthetic breast implant rupture: imaging--pictorial essay. Aesthetic Plast Surg 2011; 35:891-900. [PMID: 21487917 DOI: 10.1007/s00266-011-9694-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2010] [Accepted: 02/28/2011] [Indexed: 10/18/2022]
Abstract
In recent years, requests for breast implant surgery have occurred for several reasons. First, the number of diagnosed breast cancer cases has increased, and the number of reconstructive surgeries consequently has multiplied. Second, the number of patients who constantly try to achieve a better physical shape, corresponding in Western countries to the common image of prosperous and tonic breasts, has proliferated. These circumstances have led to an increasingly frequent need for more accurate and sophisticated imaging methods to study prosthetic breast implants and their integrity. Diagnostic imaging for the study of patients with suspected breast implant ruptures uses different techniques of radiologic investigation such as mammography and ultrasonography, even if the current gold standard is magnetic resonance imaging (MRI). This study aimed to draw attention to the main MRI signs capable of highlighting contractures or ruptures of the implants that are not always clinically detectable and thus to provide plastic surgeons with an adequate instrument for discerning any possible alterations in prosthetic implants. Furthermore, it was necessary to stress the importance of teamwork. In fact, proper cooperation and coordination between radiologists and dedicated plastic surgeons are fundamental for the proper management of patients and the complications they may experience.
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7
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Garrido I, Leguevaque P, Gangloff D, Mojallal A. [The adipose tissue transfer in the mammary parenchyma (part I): Review of the literature on modifications of the radiological images]. ANN CHIR PLAST ESTH 2010; 55:568-77. [PMID: 21144953 DOI: 10.1016/j.anplas.2009.11.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2009] [Accepted: 11/13/2009] [Indexed: 10/19/2022]
Abstract
The adipose tissue transfer (ATT) in the mammary parenchyma is a subject of controversy and generates passionate debates in scientific meetings. So far, many phenomena remain unexplained. Among these phenomena, changes in mammogram images generated by the grafted adipose tissue and the interactions between the grafted adipose tissue and a clinically undetectable breast cancer are the most important. We will present a series of articles with a critical analysis of the scientific literature on each of these phenomena. This first article presents the review of the literature on modifications of the radiological images after ATT. Two types of images are most common in mammograms after ATT. These are oil cysts and microcalcifications. Regarding to the presented review of literature, there is not yet sufficient evidence to prove a similarity or not between these images generated by the ATT and those from a breast malignancy. Therefore, clinically, patients must be included in a prospective clinical trial and in terms of research, the first step should be an exhaustive description of radiological images after ATT and a comparison of these images to images of malignancy. So, it's important to include these patients in prospective protocols with close and long term follow-up.
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Affiliation(s)
- I Garrido
- Service de chirurgie oncologique, 20-24, rue du pont-Saint-Pierre, 31052 Toulouse, France.
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8
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Mu DL, Luan J, Mu L, Xin MQ. Breast Augmentation by Autologous Fat Injection Grafting. Ann Plast Surg 2009; 63:124-7. [DOI: 10.1097/sap.0b013e318189a98a] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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9
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Maxwell GP, Gabriel A. Possible future development of implants and breast augmentation. Clin Plast Surg 2009; 36:167-72, viii. [PMID: 19055971 DOI: 10.1016/j.cps.2008.08.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Since the introduction of the silicone gel prosthesis in 1962, breast augmentation has become one of the most frequently performed operations in plastic surgery. As we strive for perfect results, it is important to continue to gather and review data evaluating innovative techniques and devices. Now we even have more options available for breast augmentation, whether we use them in combination or alone. By combining all of the available options (acellular dermal matrix products, silicone implant, fat grafting), we have been able to create "bioengineered breasts" with high patient and surgeon satisfaction. As always in plastic surgery, our concern is with safety; as newer technology and products are introduced to us, patient education, consent, and follow-up remain important.
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Affiliation(s)
- G Patrick Maxwell
- Department of Plastic Surgery, Loma Linda University Medical Center, Loma Linda, CA, USA.
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10
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Lin WC, Hsu GC, Hsu YC, Hsu HH, Li CS, Chen TYC, Huang GS. A late complication of augmentation mammoplasty by polyacrylamide hydrogel injection: ultrasound and magnetic resonance imaging findings of huge galactocele formation in a puerperal woman with pathological correlation. Breast J 2009; 14:584-7. [PMID: 19054003 DOI: 10.1111/j.1524-4741.2008.00652.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Polyacrylamide hydrogel (PAAG) was widely used for injection augmentation mammoplasty in Eastern Europe and China although uncommon in the western countries. However, the safety of this procedure remained controversial. Herein, we report a 30-year-old woman with a history of augmentation mammoplasty by PAAG injection developed galactoceles during her pregnancy. Ultrasound and magnetic resonance imaging showed huge cystic lesions in bilateral breasts; as a result, the normal breast tissue was almost completely replaced. On the basis of the imaging findings, the patient underwent mastectomy as well as immediate breast reconstruction with satisfactory outcome. It is important to be familiar with the imaging findings of this rare yet severe complication after augmentation mammoplasty in order to make an accurate diagnosis and a proper management.
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Affiliation(s)
- Wen-Chiung Lin
- Department of Radiology, Tri-Service General Hospital, Taipei, Taiwan, ROC
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11
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Cheung YW, Einstein A, Pearson G, Magno P, Johnson L. Incidental findings on SPECT/CT hybrid imaging from liquid silicone injection. J Nucl Cardiol 2009; 16:151-3. [PMID: 19152140 DOI: 10.1007/s12350-008-9007-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2008] [Revised: 08/11/2008] [Accepted: 08/13/2008] [Indexed: 10/21/2022]
Affiliation(s)
- Yat Wa Cheung
- Divison of Cardiology, Columbia University Medical Center, New York, NY, USA.
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13
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Silberstein J, Downs T, Goldstein I. Penile injection with silicone: case report and review of the literature. J Sex Med 2008; 5:2231-7. [PMID: 18657262 DOI: 10.1111/j.1743-6109.2008.00911.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Liquid injectable silicone (LIS) has been used for soft tissue augmentation in excess of 50 years. Until recently, all literature on penile augmentation with LIS consisted of case reports or small cases series, most involving surgical intervention to correct the complications of LIS. New formulations of LIS and new methodologies for injection have renewed interest in this procedure. AIM We reported a case of penile augmentation with LIS and reviewed the pertinent literature. METHODS Comprehensive literature review was performed using PubMed. We performed additional searches based on references from relevant review articles. RESULTS Injection of medical grade silicone for soft tissue augmentation has a role in carefully controlled study settings. Historically, the use of LIS for penile augmentation has had poor outcomes and required surgical intervention to correct complications resulting from LIS. CONCLUSIONS We currently discourage the use of LIS for penile augmentation until carefully designed and evaluated trials have been completed.
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Affiliation(s)
- Jonathan Silberstein
- University of California, San Diego-Division of Urology, San Diego, CA 92103-8897, USA.
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14
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Screening and diagnosis of breast cancer in augmented women. Breast Cancer 2008; 15:159-64. [DOI: 10.1007/s12282-008-0036-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2007] [Accepted: 12/21/2007] [Indexed: 10/21/2022]
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Coleman SR, Saboeiro AP. Fat grafting to the breast revisited: safety and efficacy. Plast Reconstr Surg 2007; 119:775-85; discussion 786-7. [PMID: 17312477 DOI: 10.1097/01.prs.0000252001.59162.c9] [Citation(s) in RCA: 425] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND A 1987 American Society of Plastic and Reconstructive Surgeons position paper predicted that fat grafting would compromise breast cancer detection and should therefore be prohibited. However, there is no evidence that fat grafting to breasts is less safe than any other form of breast surgery. As discussions of fat grafting to the breast are surfacing all over the world, it is time to reexamine the opinions of the 1987 American Society of Plastic and Reconstructive Surgeons position paper. METHODS This is a retrospective examination of 17 breast procedures performed using fat grafting from 1995 to 2000. Indications included micromastia, postaugmentation deformity, tuberous breast deformity, Poland's syndrome, and postmastectomy reconstruction deformities. The technique used was the Coleman method of fat grafting, which attempts to minimize trauma and place grafted fat in small aliquots at many levels. RESULTS All women had a significant improvement in their breast size and/or shape postoperatively and all had breasts that were soft and natural in appearance and feel. Postoperative mammograms identified changes one would expect after any breast procedure. CONCLUSIONS Given these results and reports of other plastic surgeons, free fat grafting should be considered as an alternative or adjunct to breast augmentation and reconstruction procedures. It is time to end the discrimination created by the 1987 position paper and judge fat grafting to the breast with the same caution and enthusiasm as any other useful breast procedure.
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Affiliation(s)
- Sydney R Coleman
- New York University School of Medicine, New York, NY 10013, USA.
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16
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Amano Y, Aoki R, Kumita S, Kumazaki T. Silicone-selective multishot echo-planar imaging for rapid MRI survey of breast implants. Eur Radiol 2007; 17:1875-8. [PMID: 17242872 DOI: 10.1007/s00330-006-0533-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2006] [Revised: 10/31/2006] [Accepted: 11/07/2006] [Indexed: 10/23/2022]
Abstract
The purpose of this study was to assess the usefulness of silicone-selective multishot echo-planar imaging (EPI) for the rapid magnetic resonance imaging (MRI) survey of breast implants. Twenty patients with bilateral breast implants underwent MRI. The use of inversion recovery and magnetization transfer pulses led to silicone-selective images. The rapid MRI survey required only 43 s, which accurately distinguished between silicone and non-silicone materials in the implants, and therefore induced the final MRI sequences appropriate for the detailed characterization of the implants. In 5 of the 20 patients, the rapid MRI survey showed implanted materials that were not indicated from clinical information. This silicone-selective multishot EPI allows a rapid survey of breast implants, which is useful to avoid unnecessary sequences in these patients.
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Affiliation(s)
- Yasuo Amano
- Department of Radiology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, Japan.
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17
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Kang BJ, Jung JI, Park C, Park WC, Jeon HM, Hahn ST, Lee JM. Breast MRI findings after modified radical mastectomy and transverse rectus abdominis myocutaneous flap in patients with breast cancer. J Magn Reson Imaging 2005; 21:784-91. [PMID: 15906336 DOI: 10.1002/jmri.20309] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
PURPOSE To evaluate the MRI findings in breast cancer patients who had undergone a modified radical mastectomy (MRM) and a transverse rectus abdominis myocutaneous (TRAM) flap. MATERIALS AND METHODS MRI was performed on 20 patients who had been diagnosed with breast cancer and had undergone an MRM and TRAM flap. The results were examined in terms of MRI's ability to detect the flap and assess possible postoperative changes and recurrence. In addition, MRI images of the opposite breast were analyzed. Follow-up examinations were carried out on 11 patients, and all changes were assessed. RESULTS The flap was clearly visualized by MRI in all of the patients. The signal intensity of the flap was equivalent to that of fat. The contact zone between the TRAM flap and the mastectomy site was enhanced after contrast infusion. Postoperative changes, such as skin thickening (n=20), edema (n=2), fluid collection (n=3), hematoma (n=1), and fat necrosis (n=3), were detected. In two patients, artificially inserted fat tissue was identified. On the MRI of the opposite breast, enhancing lesions were detected in seven patients. In one patient with this finding, ductal carcinoma in situ was diagnosed. On the follow-up MRI, a decrease in skin thickening, fat necrosis, and hematoma was detected. CONCLUSION MRI is an effective method for lesion detection and evaluation of postoperative changes after MRM and TRAM flap, as well as for evaluation of the opposite breast.
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Affiliation(s)
- Bong Joo Kang
- Department of Radiology, St. Mary's Hospital, Catholic University of Korea, Seoul, Korea
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Pineda V, Cáceres J, Pernas JC, Català J. Retromammary fluid collection as a late complication of breast implants: magnetic resonance imaging findings. J Comput Assist Tomogr 2004; 28:386-9. [PMID: 15100545 DOI: 10.1097/00004728-200405000-00014] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Imaging examinations, particularly magnetic resonance imaging (MRI), play an important role in the diagnosis of breast implant complications. Two cases of retroprosthetic serous-like fluid collection, an unusual late complication that has not been described previously in the literature, are presented. It is important for radiologists to know the MRI findings of this complication, which suggest the correct diagnosis, avoiding unnecessary additional procedures.
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Affiliation(s)
- Victor Pineda
- Department of Radiology, H. G. Vall d'Hebron, Universitat Autónoma de Barcelona, Spain.
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Sakai Y, Wakamatsu S, Hirakawa K. Identification of foreign material from abscesses after injection mammaplasty, by implant alleged to be collagen. Plast Reconstr Surg 2003; 112:931-3. [PMID: 12960895 DOI: 10.1097/01.prs.0000074486.42036.b9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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20
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Abenavoli FM, Corelli R, Giordano L. Breast implant evaluation: pitfall of magnetic resonance imaging. Plast Reconstr Surg 2003; 111:507-8. [PMID: 12496644 DOI: 10.1097/00006534-200301000-00112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
In summary, it is an exciting time in breast imaging with many tools being brought to bear on an ever more common problem. The challenge for this decade will be to develop optimal cost-effective strategies to use all the tools now available with minimal discomfort and disfigurement to the patient.
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Affiliation(s)
- W A Berg
- Department of Radiology and Greenebaum Cancer Center, University of Maryland, 419 W Redwood St, Suite 110, Baltimore, MD 21201, USA
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22
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Women's Health LiteratureWatch & Commentary. J Womens Health (Larchmt) 1998. [DOI: 10.1089/jwh.1998.7.763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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